The recently commercially available Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) utilizes a completely subcutaneous electrode configuration to treat potentially lethal ventricular tachyarrhythmia. Clinical trials have proven its effectiveness in detecting and treating ventricular fibrillation and tachycardia. The S-ICD offers the advantage of eliminating the need for intravenous and intracardiac leads and their associated risks and shortcomings. However, its major disadvantage is its inability to provide bradycardia rate support and anti-tachycardia pacing to terminate ventricular tachycardia. This article reviews the S-ICD clinical trials and the advantages and disadvantages of this novel technology to help the physician identify its role and select candidates that will benefit from this device.